BOTOX^® Injection for Facial Wrinkles

Botulinum Toxin Type A (BOTOX®) is produced by the bacterium Clostridium botulinum. It is the same toxin that causes a form of muscle paralysis called “botulism” when present in very large amounts. BOTOX has been used safely for many years in extremely small doses to relieve uncontrollable muscle twitching or spasms. More recently, it is being used successfully to reduce or eliminate facial wrinkles on the upper third of the face including “crow’s feet” around the eyes, and “frown lines” on the forehead.

As we age, and often in young adults, wrinkles form around the eyes, across the forehead, and between the eyebrows. These are formed by repetitive movement of muscles attached to the skin for facial expression. Over time, deep furrows may form that give the perpetual appearance of tiredness, frustration, anger, or aging. By injecting selected muscles with very small doses of BOTOX, the muscles are weakened giving a very desirable appearance of relaxation and smoothness in the overlying skin.

BOTOX is extremely safe to use for facial wrinkles. There have been no reports of allergic reaction, anaphylaxis, or systemic reactions (illness). It has been used safely for over 15 years at much higher doses in patients with neuromuscular disorders including strabismus (lazy eye) and blepharospasm (uncontrolled eye blinking or twitching). In 1989, Dr. Carruthers, a dermatologist in Vancouver, Canada, first used it for facial wrinkles. A major study of this technique was completed in 1995 with a review published in The Journal of the American Academy of Dermatology.

Patient is attempting to raise brows in the "AFTER" picture. Notice how smooth the lines have become.

The most common undesirable side effect of BOTOX is related to migration of the toxin from the injection site. This may cause a weakness or mild drooping of the eyebrow or eyelids that is temporary, usually lasting one to three weeks. This is a rare occurrence (approximately 1 out of 100 persons) and may not be noticed by the patient. The patient can minimize the chances of this occurring by not rubbing or massaging the area for 12 hours after injection. Other unavoidable side effects of the procedure include discomfort from the injections and possible slight bruising at the site of the injections. You are advised not to use aspirin, aspirin containing products, or other non-steroidal anti-inflammatory medications, Vitamin E or C, fish oils, or alcohol for two weeks before to two weeks after injection to minimize your risk of bruising. Also, as with any procedure, there is a very small risk of infection.

BOTOX works by weakening the muscles beneath the skin of the eyes and forehead to alter facial expression and decrease facial wrinkles. It takes three to five days after the injections to see the results. Occasionally, a second injection is required to achieve the desired effect. You can expect the results to last between three and six months. It is impossible to estimate exactly how long it will last because everyone is different. When the beneficial effects start to wear off, the wrinkles will return, but often they are not as deep. You will need two to three sessions of injections per year to maintain the acquired beneficial effects.

BOTOX is utilized to enhance your facial appearance. It does not replace standard facial plastic surgery procedures such as a face lift, a forehead lift, or eyelid surgery. It does, however, provide an important new technique to address areas not improved by surgery or areas not yet in need of surgical correction. It is important to note that some deep wrinkles are not improved with BOTOX. Wrinkles that are present at rest and are not caused by muscle movement under the skin will not be improved. They are usually the result of sun-damaged skin or scarring from prior trauma.